Impact of Anti-obesity Medication Initiation and Duration on Weight Loss

Real-world studies of anti-obesity medication (AOM) use have shown lower adherence and persistence than clinical trials; however, the impact of this reduced adherence in real-world settings remains largely unexplored. This study aimed to evaluate the effects of AOM use, timing of initiation, and duration on 18-month weight loss outcomes in comprehensive obesity care practice, offering critical insights into the role of adherence in optimizing treatment efficacy.

This retrospective cohort study assessed the electronic health records of adults with a body mass index (BMI) ≥ 30 kg/m² enrolled in a digital obesity program for ≥ 18 months. Participants were categorized by AOM use, initiation timing (early vs. delayed), and duration (short vs. long).

This study of 1282 participants showed that AOM users had greater weight reduction than non-users. Long- and short-duration AOM users experienced significantly more weight loss than short-duration users, with no difference between early and delayed starters. Second-generation semaglutide users were more likely to reach the 20% weight loss milestone, especially with longer use.

Long-term AOM use significantly improved weight loss in comprehensive obesity care. Furthermore, the success of non-AOM users highlights the value of intensive behavioral programs, indicating the need for personalized treatment to optimize cost-effectiveness and outcomes.